A M Jabr SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

A M JABR SC

Practice address

2222 W Division St
Suite 260
Chicago, IL 60622-2717

Phone

(773) 227-3770

Fax

(773) 486-5224

NPI assigned

Nov 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ayman Jabr, MD

Title

President

Phone

(773) 227-3770

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• A M Jabr MD SC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1205027810

  O20041109001185

  Same enrollment

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245317536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-227-3770",
            "fax_number": "773-486-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST",
            "address_2": "SUITE 260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222717",
            "telephone_number": "773-227-3770",
            "fax_number": "773-486-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A M JABR SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JABR",
        "authorized_official_first_name": "AYMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-227-3770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1634771",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chicago, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.